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Small centrum ovale infarcts on diffusion-weighted magnetic resonance imaging
Kiminobu Yonemura1, Kazumi Kimura, Kazuo Minematsu
1Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, Japan. kyonemu@aol.com
Stroke
|June 8, 2002
Summary
Small centrum ovale infarcts (SCOIs) detected by diffusion-weighted MRI (DWI) are often linked to large-vessel and heart diseases. These findings suggest SCOIs should be differentiated from typical lacunar infarcts.
Area of Science:
- Neurology
- Radiology
- Cardiology
Background:
- Small centrum ovale infarcts (SCOIs) are often misclassified as lacunar infarcts.
- Medullary artery occlusion causes SCOIs, affecting white matter.
- Diffusion-weighted MRI (DWI) offers advanced visualization of brain infarcts.
Purpose of the Study:
- To differentiate clinical characteristics of SCOIs from small basal ganglia infarcts (SBGIs).
- To compare SCOIs and SBGIs using diffusion-weighted MRI (DWI).
Main Methods:
- 38 patients with SCOIs and 68 with SBGIs (<=15 mm) were selected from 582 acute ischemic stroke patients.
- Conventional MRI and DWI were used for infarct detection.
- Clinical symptoms, vascular risk factors, heart disease, arterial disease, and recurrent stroke were compared.
Main Results:
- DWI detected all SCOIs and SBGIs; conventional MRI detected only 47% of SCOIs and 87% of SBGIs.
- SCOI patients showed more frequent abrupt symptoms, emboligenic heart disease, ipsilateral arterial occlusive disease, and recurrent stroke.
- SCOI patients less frequently presented with classic lacunar syndromes compared to SBGI patients.
Conclusions:
- Symptomatic SCOIs identified by DWI are associated with large-vessel and cardiac diseases.
- Distinguishing SCOIs from lacunar infarcts is crucial for appropriate clinical management.
- Further research is needed to fully understand the implications of SCOIs.